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  Discussion on New diagnosis of coronary band dystrophy very long post
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hothoof1

Posted on Friday, Feb 8, 2008 - 11:31 pm:

I have to apologize ahead of time for the length of this post, but in view of the dim prognosis I am trying to provide as much information as possible.

In November, my 8 yr old mustang gelding started showing some irritation and scaling on all four hoofs at his coronary band with a change in exterior outer section of hoof wall (wavy and less shiny). My vet determined it was scratches based on visually viewing the area.

My 8 yr old is in excellent health, good appetite, great coat and no sign of lameness or swelling. There is sensitivity when the heel bulbs are pushed and if scabs (scales) are picked off coronary bands. No cauliflower growths on heels or bands. It is more like hard layered scaling flowing downward not out. If scaling is untreated, irritation does develop as the scales approach the hoof cleft.

Chance lives in pasture and apparently due to the local weather (unusual wet and warm winter for FL) my vets were seeing quite a few cases of of coronary and pastern irritations. A topical mixture of Corona, Fuluvcin (sp?), DMSO was prescribed after washing the affected area with a Novaslan mixture. This treatment was apparently very successfully on the other horses in the area, but really did not help with Chance. Instead he started to have lesions develop mainly around the heel bulbs that were starting to ooze pus.

Phase 2 of treatment started. Shampoo area with Keto-Chlor and flush with T8 Keto. Dry area and put on triple antibiotic w/7 days of Sulfamethoxazole & Trimethoprim Double Strength 10 tablets twice a day. I actually went to a mix of Desitin, Triple Antibiotic Ointment(Bacitracin-Neomycin Sulfate-Polymyxin B Sulfate) and 1% HyDrOcortisone cream.
Major improvement noted with in days. Scaling on heels gone with some hair growth on back of heels; however, ridging on coronary band is still present. After oral antibiotics stopped, some increase in scaling, however, as long as topical mixture applied every day to every other day additional scaling does not occur but coronary band still ridged. When topical stopped by 3rd or 4 day, scaling begins to appear.

Called vet to come out to biopsy the area. When came out, my vet did not want to biopsy the area as feared that the biopsy would result in serious hoof wall damage, so all topicals were stopped and Chance was placed back on Sulfamethoxazole & Trimethoprim Double Strength now 12 tablets twice a day just to see how it goes.

He has been on that for 10 days. Scaling has re-occurred although it seems at slightly slower pace than in the past. I called the vet for a recheck. My vet called me back and left a message that they were going to check with Dr Miller at Cornell for an opinion, but that they feel Chance has Coronary Band Dystrophy since he has not responded to antibiotics and irritation is on all four coronary bands. Note: he has 3 white feet that do seem worse than his black foot; however, black hoof is also affected just not as severely. He was put back on topical antibiotics for now.

Based on the material, I have reviewed here the prognosis seems dim and there seems to be little information available on this. I do have a number of questions and concerns that I would love to have answered if possible.

First, no biopsy or culture has been done at this time. CBD seems very rare. Is there a probability, that this could still be bacterial or fungal infection that is just not responsive to the class of antibiotics and treatment that has been prescribed so far? If this is CBD, why the improvement when both topical and oral antibiotics are prescribed? The changed hoof wall has not yet grown out to the point it is weight bearing. At that time, does he become lame or get laminitis or is there just a reduction in horn quality and he maintains quality of life? If this is CBD, is this a fatal diagnosis and if so, any idea of timeframe and disease progression? What should my next step be? Of all the horses I have owned, this one is very special to me.
Moderator:
DrO

Posted on Saturday, Feb 9, 2008 - 9:58 am:

Welcome Kathy,
Sorry to meet you over such a serious problem and though this is serious I would not say the prognosis dim, you have only been dealing with this for about 3 months I still think you have a fair chance of beating this thing. Though I have had cases of coronary band disease, one quadrilateral, we eventually got all the cases cured. Apparently I have never had a true case of CBD since by definition it is not treatable so the information on CBD has been gleaned from research into the condition and not personal experience.

Taking your questions in order:
1) Yes this is possible enough that it should be pursued.
2) CBD, by definition, is not responsive to treatment so your temporary treatment success suggests this may be something else. Don't forget topical steroids were given so along with infectious causes this may be an allergic or autoimmune problem.
3) It depends on the severity of the damage but the horses I have seen with chronic coronitis and wall damage did not become lame do to wall quality but because of sores on the coronet. Laminitis is not reported in the literature with CBD.
4) Cases will differ in their severity and rate of progression. The CBD is not fatal but some may find the chronic dermatitis / keratitis difficult to live with and if the sores bad enough elect euthanasia.
5) Your next step needs to be decided by your veterinarian but since you have had one effective therapy, you and your vet might consider a much longer course of that exact same therapy.

Otherwise follow the diagnostic/therapeutic recommendations in the article Kathy. If you decide to biopsy it is important that the horse be off therapy for about 14 days before taking the sample. By carefully trying to rule in or out the similar looking diseases listed in the article you know you are doing all you can do for your horse as they are usually treatable.
DrO
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